Parkinson's Disease: Pathophysiology and Nursing Care

1.  Define Parkinson’s disease.Chronic, slow, progressive neurodegenerative disorder caused by loss of dopaminergic neurons in the substantia nigra of the basal ganglia characterized by tremors at rest, rigidity, bradykinesia, and postural instability.2.  Describe the pathophysiology of Parkinson’s disease.Role of DA producing neurons in the substantia nigra.Imbalance of two neurotransmitters dopamine (DA) and acetylcholine (ACh).3.  Identify the etiology of Parkinson’s disease.Possible causative factors of PD.Other medical conditions with Parkinson-like symptoms. 4.  State the incidence of Parkinson’s disease.Age group most affectedGender5. Describe the clinical manifestations (motor and non-motor features) of Parkinson’s disease.Primary:TremorsRigidityAkinesia/bradykinesiaPostural instability Secondary:Fine motor function problemsDysarthriaHypophoniaMasklike faceFatigue and weaknessAutonomic manifestationsCognitive impairmentsEmotional labilitySleep disturbance 6. Describe the stages of Parkinson’s disease.Stages I-V  7.  Understand the diagnosis of Parkinson’s disease.History and clinical findingsRule out other disordersConventional diagnosis 8.  Identify health problems in patients with Parkinson’s disease. Worsening of motor and nonmotor symptoms as the disease process progresses. 9. Describe nursing interventions used to promote adaptation in patients with Parkinson’s disease. General principles and specific interventionsTeam approachReferralsEducationDischarge planningCommunity care and involvementNurse’s role10. Understand nonpharmacological strategies to manage the signs and symptoms associated with Parkinson’s disease.Exercise therapySpeech therapyRelaxation techniquesSelf-care managementBalance nutritionStrategies to prevent constipation, anxiety, pain, sleep disorders, and activities to improve cognitionUse of complementary therapies 11. Identify surgical procedures that may be implemented to alleviate the symptoms of Parkinson’s disease.ThalamotomyPallidotomyDeep brain stimulation (DBS)Fetal-adrenal transplantsStem cell transplants